低NIHSS评分伴大血管闭塞性急性缺血性卒中机械取栓治疗效果分析  

Analysis of mechanical thrombectomy for acute ischemic strokes with low NIHSS scores and large vessel occlusion

作　　者：曹杨 张凯[2] 张士永[3] Cao Yang;Zhang Kai;Zhang Shiyong(Department of Neurosurgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Neurology,Capital Medical University,Beijing 100069,China;Department of Neurointervention,Beijing Fengtai You'anmen Hospital,Beijing 100054,China)

机构地区：[1]首都医科大学附属北京地坛医院神经外科,100015 [2]首都医科大学神经内科学,北京100069 [3]北京丰台右安门医院神经介入科,100054

出　　处：《中华脑血管病杂志（电子版）》2023年第2期107-111,共5页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

摘　　要：目的分析低美国国立卫生研究院卒中量表(NIHSS)评分伴大血管闭塞性急性缺血性卒中患者机械取栓的治疗效果。方法收集2020年1月至2022年6月右安门医院神经介入科收治的急性缺血性卒中机械取栓患者的临床资料,其中25例患者表现为低NIHSS评分伴大血管闭塞,回顾性分析并总结此类患者的临床特点,采用Wilcoxon秩和检验分别比较基线NIHSS评分与术后24 h及90 d NIHSS评分的差异。结果25例患者中男性19例(76.0%),年龄为(61±13)岁,高血压为常见合并症(56.0%,14/25),Alberta卒中项目早期CT评分为10分者占56.0%(14/25),病因分型以大动脉粥样硬化型为主(84.0%,21/25),成功开通22例(88.0%,22/25),颅内无症状出血2例(8.0%,2/25),90 d NIHSS评分低于基线NIHSS评分[1(0,2)分vs 4(3,4)分],差异具有统计学意义(Z=-2.335,P=0.020),90 d随访良好预后率为92.0%(23/25)。结论机械取栓手术作为低NIHSS评分伴大血管闭塞性急性缺血性卒中患者的治疗方案是可行的,并且有较高的安全性及血管再通率。Objective To analyze the therapeutic effect of mechanical thrombectomy in patients with acute ischemic strokes with low National Institute of Health stroke scale(NIHSS)scores and large vessel occlusions.Methods The clinical data of acute ischemic stroke patients with mechanical thrombectomy admitted to the Neurointerventional Department of You'anmen Hospital from January 2020 to June 2022 were collected.Among them,25 patients presented with low NIHSS scores and large vessel occlusions.The clinical characteristics of these patients were retrospectively analyzed and summarized.Wilcoxon rank-sum test was used to compare the difference between baseline NIHSS scores and postoperative NIHSS scores at 24 hours and 90 days after the operation.Results Among the 25 patients,19 were male(76.0%),aged(61±13)years.Hypertension was a common comorbidity(56.0%,14/25).Patients with Alberta stroke program early CT score 10 accounted for 56.0%(14/25).The main etiological type was large-artery atherosclerosis(84.0%,21/25).22 patients(88.0%,22/25)were successfully recanalized and 2 patients(8.0%,2/25)had asymptomatic intracranial hemorrhage.The NIHSS score at 90 days was lower than the baseline NIHSS score[1(0,2)score vs 4(3,4)score],with a statistically significant difference(Z=-2.335,P=0.020).The good prognosis rate was 92.0%(23/25)at 90 days follow-up.Conclusion Mechanical thrombectomy is feasible as a treatment for patients with low NIHSS scores and large vessel occlusions,and has high safety and vessel recanalization rate.

关 键 词：卒中 美国国立卫生研究院卒中量表 大血管闭塞 机械取栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]